PD42-10 MECHANICAL INDICATIONS FOR INFLATABLE PENILE PROSTHESIS REVISION

INTRODUCTION AND OBJECTIVE: Despite advances in design, in ﬂ atable penile prostheses (IPPs) remain susceptible to mechanical degradation with repeated use. We sought to characterize IPP component failure at time of device revision and stratify by manufacturer [American Medical Systems (AMS) and Coloplast (CP)]. METHODS: Retrospective review of our penile prosthesis database between July 2007 e May 2022 was conducted, identifying men who underwent revision surgery. Mechanical indications for sur- gery were categorized by location (e.g

INTRODUCTION AND OBJECTIVE: Surgical penile augmentation for aesthetic purposes is an invasive procedure that carries with it an increased risk of medicolegal liability. The purpose of this study is to investigate the factors associated with malpractice litigation surrounding penile augmentation surgery.
METHODS: We reviewed the Nexis Uni legal database for state and federal cases using the terms "penile" or "penis" and "enlargement" or "augmentation" or "enhancement". Variables extracted included trial date, demographic information, procedure performed, alleged breach of duty, alleged damages, and legal outcome. Data were analyzed using descriptive statistics.
RESULTS: The initial database search yielded 48 cases that were narrowed to six after exclusions. The original surgeries took place between 1993 and 2004 while the cases were between the years of 2001 to 2008. Most cases were processed in state court systems (83%) with the majority taking place in New York (66.67%). Half of the physician defendants were urologists and half were plastic surgeons. The alleged breaches of duty included lack of informed consent (44.44%), negligence (33.33%), and deceptive business practices (22.22%). The verdict in 60% of the cases favored the defendant. Suspensory ligament release accounted for the most common (44.4%) type of augmentation surgery performed with the remaining being unspecified (33.3%), autologous fat injection (11.10%), and autologous fat grafting (11.10%). The most commonly alleged damages were equal amongst erectile dysfunction, decreased sensation, and need for additional corrective surgeries at 23.1% each.
CONCLUSIONS: The relatively few cases since the 2000's likely reflects a trend towards nonsurgical methods of penile augmentation. The main issues involved in malpractice litigation in penile augmentation surgery included lack of informed consent, negligence, and deceptive business practices. Additionally patients complained of a number of damages including sexual dysfunction and the need for corrective surgeries. Given that that total number of penile augmentation is not known, the prevalence of postoperative litigation cannot be estimated. Nevertheless, penile augmentation surgery remains investigational and providers should be aware of its medicolegal implications.

PD42-12 DELAYED CLOSED-SUCTION DRAIN REMOVAL AFTER INFLATABLE PENILE PROSTHESIS: A MULTI-INSTITUTIONAL EXPERIENCE
Luke Shumaker*, Birmingham, AL; Nicholas Zulia, Jonathan Beilan, Largo, FL; Emmett Kennady, Nicolas Ortiz, Charlottesville, VA; Adam Baumgarten, Birmingham, AL INTRODUCTION AND OBJECTIVE: There is little published data regarding percutaneous drain (PD) duration after inflatable penile prosthesis (IPP) placement. The dissection associated makes scrotal hematomas common in the first 72 hours. Maintaining a percutaneous drain represents a strategy to reduce scrotal hematoma formation. However, a percutaneous tract also represents a feasible path for seeding of a new prosthesis. Given the severe consequences of infection, establishing comparable outcomes for delayed drain removal patients is necessary. Here we detail rates of infection, hematoma, device explantation and other standard post IPP metrics in a multiinstitutional cohort with delayed PD removal (48-hours or greater).
METHODS: Data was collected retrospectively for 224 patients undergoing virgin IPP placement with delayed PD removal. Cases were performed by three surgeons at three high-volume centers between 01/ 01/2020 and 3/31/2022. It was the practice of these surgeons to leave PDs 48 hours or greater. 15 patients had PDs removed before 48 hours Vol. 209,No. 4S,Supplement,